Table 3.
Risk factors for 30-day mortality (univariate and multivariate analysis)
| Variable | All episodes, N = 317 (%) | Alive, N = 247 (%) | Died, N = 70 (%) | p | OR | 95% CI | p |
|---|---|---|---|---|---|---|---|
| Demographics | |||||||
| Sex, male | 184 (58.0) | 154 (62.3) | 46 (61.4) | 0.89 | – | – | – |
| Age ≥ 50 years | 275 (86.8) | 212 (85.8) | 63 (90.0) | 0.43 | – | – | – |
| Mean age (± SD), years | 65.4 ± 17.0 | 64.8 ± 16.8 | 67.2 ± 17.7 | 0.30 | – | – | – |
| Median hospital stay until Candida BSI (IQR), days | 16 (7–31) | 15 (6–29) | 20 (10–34) | 0.09 | – | – | |
| Hospital ward | |||||||
| General ward | 254 (80.1) | 201 (84.1) | 47 (67.1) | 0.003 | 1.9 | 0.93–4.30 | 0.78 |
| Intensive care unit | 63 (19.9) | 38 (15.9) | 23 (32.9) | ||||
| Charlson comorbidity index | 3.4 ± 2.7 | 3.0 ± 2.4 | 4.6 ± 3.1 | < 0.001 | 1.28 | 1.13–1.45 | < 0.001 |
| Underlying condition | |||||||
| Solid tumor | 114 (35.9) | 91 (36.8) | 23 (32.9) | 0.57 | – | – | – |
| Cardiovascular disease | 102 (32.2) | 72 (29.1) | 30 (42.9) | 0.04 | – | – | – |
| Diabetes mellitus | 90 (28.4) | 68 (27.5) | 22 (31.4) | 0.55 | – | – | – |
| Chronic lung disease | 51 (16.1) | 36 (14.6) | 15 (21.4) | 0.20 | – | – | – |
| Chronic kidney failure | 50 (15.8) | 36 (14.6) | 14 (20.0) | 0.27 | – | – | – |
| Chronic liver disease | 41 (12.9) | 26 (10.5) | 15 (21.4) | 0.02 | – | – | – |
| Solid organ transplantation | 27 (8.5) | 22 (8.9) | 5 (7.1) | 0.81 | – | – | – |
| Hematological malignancy | 20 (6.3) | 15 (6.1) | 5 (7.1) | 0.78 | – | – | – |
| Hematopoietic stem cell transplantation | 9 (2.8) | 6 (2.4) | 3 (4.3) | 0.41 | – | – | – |
| Risk factors for candidemia | |||||||
| Previous antibiotic therapy | 297 (93.6) | 232 (93.9) | 65 (92.9) | 0.78 | – | – | – |
| Central venous catheter | 225 (71.0) | 171 (69.2) | 54 (77.1) | 0.23 | – | – | – |
| TPN during candidemia | 158 (49.8) | 118 (47.8) | 40 (57.1) | 0.17 | – | – | – |
| Previous corticosteroid therapy | 72 (22.7) | 53 (21.5) | 19 (27.1) | 0.33 | – | – | – |
| Abdominal surgery | 85 (26.8) | 65 (26.3) | 20 (28.6) | 0.76 | – | – | – |
| Immunosuppressive therapy | 47 (14.8) | 39 (15.8) | 8 (11.4) | 0.45 | – | – | – |
| Neutropenia | 10 (3.2) | 7 (2.8) | 3 (4.3) | 0.46 | – | – | – |
| Previous antifungal treatment | 49 (15.4) | 37 (15.0) | 12 (17.1) | 0.71 | – | – | – |
| Source of infection | |||||||
| Central venous catheter | 141 (44.5) | 122 (49.9) | 19 (27.1) | 0.001 | 0.42 | 0.20–0.88 | 0.02 |
| Primary | 98 (30.9) | 71 (28.7) | 27 (38.6) | 0.14 | – | – | |
| Abdomen | 39 (12.3) | 22 (8.9) | 17 (24.3) | 0.001 | 1.89 | 0.76–4.66 | 0.17 |
| Urinary tract | 23 (7.3) | 22 (8.9) | 1 (1.4) | 0.03 | 0.11 | 0.12–1.02 | 0.05- |
| Infective endocarditis | 3 (0.9) | 3 (1.2) | 0 (0) | 1 | – | – | – |
| Other | 13 (4.1) | 7 (2.8) | 6 (8.6) | 0.05 | – | – | – |
| Septic shock | 99 (31.2) | 65 (26.3) | 34 (48.6) | 0.001 | 2.14 | 1.08–4.24 | 0.02 |
| Initial adequate antifungal therapy | 130 (41.0) | 95 (38.5) | 35 (50.0) | 0.09 | 1.41 | 0.71–2.81 | 0.32 |
| Adequate source control of the infection* | 124/288 (43.1) | 94/225 (41.8) | 30/63 (47.6) | 0.47 | 1.68 | 0.84–3.35 | 0.14 |
| Hemodialysis after candidemia onset | 7 (2.2) | 2 (0.8) | 5 (7.1) | 0.007 | 8.55 | 1.35–53.95 | 0.02 |
*The source of the infection was susceptible of control in 288 patients
BSI bloodstream infection, IQR interquartile range, SD standard deviation, TPN total parenteral nutrition